LANDOWNER PERMISSION FORM

							                                   LANDOWNER PERMISSION FORM

Dear Landowner,

I am a State and Federally licensed Falconer practicing the time-honored art and sport using trained hawks,
falcons and other birds of prey to hunt small game only for purposes of providing the hawk it's own
preferred food source in a natural environment. The hawk's food source consists mainly of small rodents,
such as mice and rats and sometimes small mammals. My hawk poses little or no danger to people,
children, pets, wild game or livestock.

By sending you this letter, I ask you for the privilege of your allowing me to utilize your land on a
permissive and limited basis to allow my hawk to catch it's own food. This will be done only with your
permission and on a limited basis and by the terms set forth by you.

I have the utmost respect for your property and possessions and I understand that if I am allowed the
privilege to utilize your land to "feed", and train the hawk that I am fully liable for any damage that may be
caused. I am properly licensed and posses valid falconry and hunting licenses issued by the U.S. Fish &
Wildlife Service and the Florida Game & Fresh Water Fish Commission.

By signing below, I acknowledge and accept all risks and terms involved in this activity and hold you, the
landowner(s), lessee(s) or agent(s) harmless and release the same from liability, injury or death of any party
from my participating in this activity upon your land or property.

I sincerely thank you and I am very grateful for your time and for allowing me the opportunity and
privilege to practice this time honored art and sport.

My name is John B. Sims III
Address: 4611 South University Drive
Apt. 413
Davie, Florida 33328

Phone Number: (954) 680-6696 Home (305) 637-3737 Work

Vehicle: Ford F-250 SD Black/Grey Tag #: KA4ZAY Florida


_____________________________________________
Falconer's Signature         By signing this document, falconer accepts the landowner terms stated.


Landowner Information (Please print):

Name:________________________________________________________

Address:______________________________________________________

City, State, Zip:________________________________________________

Phone #:___(______)___________________________________________

Signature:_____________________________________________________